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BETA v.3.0

2025 CPT code 58740

Lysis of adhesions (salpingolysis, ovariolysis).

Modifiers may be applicable. Modifier 22 (Increased Procedural Services) may be used if the lysis of adhesions is significantly more extensive than usual. Modifier 59 (Distinct Procedural Service) may be necessary in some cases to indicate that the lysis is a separate procedure from other services performed during the same surgical session.

Medical necessity must be established for 58740. This typically involves demonstrating that the adhesions are causing significant symptoms (e.g., pain, infertility) and that surgical lysis is the appropriate treatment.The documentation should clearly link the procedure to the patient's condition and expected improvement.

The surgeon is responsible for performing the procedure, including patient positioning, administering anesthesia, making the incision, lysing adhesions, performing chromotubation (if necessary), controlling bleeding, closing the incision, and placing a Foley catheter.Thorough documentation is crucial.

IMPORTANT:For laparoscopic approach, use 58660. For excision or destruction of endometriomas, open method, see 49203-49205, 58957, 58958. For fulguration or excision of lesions, laparoscopic approach, use 58662.

In simple words: This surgery removes scar tissue around the fallopian tubes and ovaries. The doctor makes a cut in the lower belly to access the area and removes the scar tissue with tools like scissors, a laser, or a heated instrument. They might also use dye to check if the fallopian tubes are open.After the procedure, the belly is stitched closed and a catheter is placed to help with drainage.

This procedure involves the surgical removal of adhesions around the fallopian tubes and/or ovaries through an abdominal incision.The surgeon makes an incision in the lower abdomen, inspects the affected area, and then breaks down the scar tissue using instruments like scissors, a laser, or electrocautery. A chromotubation may be performed to assess tubal patency. The abdomen is then closed, and a Foley catheter is placed.

Example 1: A patient with a history of pelvic inflammatory disease presents with infertility.Diagnostic laparoscopy reveals extensive adhesions around the fallopian tubes and ovaries.The surgeon performs a laparotomy with lysis of adhesions (58740) to restore tubal patency., A patient experiences chronic pelvic pain due to adhesions from a prior C-section.The surgeon performs a laparotomy and lyses the adhesions (58740) to alleviate the pain., During a laparotomy for another gynecological procedure, the surgeon encounters significant adhesions obstructing access to the surgical site.The surgeon lyses these adhesions (58740) to facilitate the primary procedure.

Documentation should include the location, extent, and density of the adhesions, the methods used for lysis, the operative time, and any associated procedures.If chromotubation is performed, the results should be documented.The medical necessity of the procedure, including the patient's symptoms and the impact of the adhesions on their health, should also be clearly documented.

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